Individual provider Active NPI

Frank A Smith, MD

  • Family Medicine Physician
  • Crockett, TX
National Provider Identifier
1376535542
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D7878 Issued in TX
Practice address
1122 E Loop 304
Crockett, TX 75835-1810
Phone
(936) 544-2157
Fax
(936) 544-5572
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D7878 TX Primary

Addresses

Primary practice location

1122 E Loop 304
Crockett, TX 75835-1810

Mailing address

PO Box 1189
Crockett, TX 75835-1189
Phone (936) 544-2157

Other identifiers 1

IdentifierTypeStateIssuer
089910602MedicaidTX

Other names 1

  • Dr. Frank A Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214001009 TX Practitioner - Family Practice 5193636157 Practice locations: Crockett, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D7878TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crockett Clinic LLP Family Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1376535542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351189",
            "telephone_number": "936-544-2157",
            "fax_number": "936-544-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E LOOP 304",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351810",
            "telephone_number": "936-544-2157",
            "fax_number": "936-544-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FRANK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D7878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089910602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRANK",
            "last_name": "SMITH",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Crockett, TX

Sources for this page

Verify at the official NPI Registry.